The Psychiatrist Ethics of “Take Care of Yourself and Each Other”

PSYCHIATRIC VIEWS ON THE DAILY NEWS

For the past few years, I have increasingly paid attention to the news from a variety of sources to help write the weekdays Psychiatric Views on the Daily News columns. Often, an idea for a column comes from the television news shows.

There are a couple of regular news shows that we watch. One is “CBS Sunday Morning,” which I have discussed. The other is the NBC news at 5:30 PM.

For the last decade, Lester Holt has been the weekdays anchor of that news show. He always closed the show with a saying: “Take care of yourself and each other.” Friday he ended his last show as anchor with that quote. It seems fitting, then, to dedicate this column to him and to discuss the psychiatric implications of that statement.

On the surface, the closing remark has obvious connections to psychiatry and the rest of medicine. Take good medical care of ourselves and our patients. But there is much more to consider. Why should taking care of yourself come first? Perhaps that is consistent with the usual airlines advice before takeoff that, in times of danger, put your own mask on before attending to your loved ones.

However, the statement contradicts our medical ethics, as in the Preamble of the AMA’s Ethical Principles. It states that the needs of patients should come first and foremost, then secondarily our own needs, as well as that of colleagues and society. Even if Holt meant the 2 priorities to be equal in value, that is not the case in medicine.

No wonder, then, that our burning out has become epidemic and remained so for years. Even if our systems are oppressive and disempowering, and the financial business ethics are often prioritized, we plow through with high resilience and take as good care of patients as circumstances allow. We do not strike and we don’t rally publicly, that is, until we finally did have a rally for mental health at the recent American Psychiatric Association Annual Meeting to protest the governmental cuts in resources.

Without detailed historical information, I can only assume why patients were put first and remained that way in our longstanding ethical principles. Helping patients is the conscious basis of why most of us became physicians and why we endured long and arduous training followed by demands on our time and availability. Besides, putting ourselves first or equal could seem selfish and suspicious.

Nevertheless, after many years of leading large systems of care and ethics committees, I would put our own needs at least equal to that of patients. I agree with Holt’s sign off for ourselves. Do you?

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third